Multisystem inflammatory syndrome in children (MIS-C) and “Near MIS-C”: A continuum?

IntroductionReports of multisystem inflammatory syndrome in children (MIS-C), following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, have been increasing worldwide, with an incidence varying significantly across studies based on the definition used for the diagnosis. At our tertiary medical center in Lebanon, we encountered several cases that presented a diagnostic challenge because they mimicked MIS-C but did not meet the US Centers for Disease Control and Prevention (CDC) definition. We decided to review these cases and describe their features in comparison with cases that met the CDC criteria of MIS-C and those that had an alternative diagnosis.MethodsThis is a retrospective chart review of subjects aged <19 years old admitted to the American University of Beirut Medical Center (AUBMC) between March 1, 2020, and May 31, 2021, with suspected or confirmed MIS-C, following documented COVID-19 infection, with sufficient or insufficient criteria for diagnosis. Subjects were classified into 3 groups: “MIS-C”, “Near MIS-C” and “Alternative Diagnosis”.ResultsA total number of 29 subjects were included in our cohort. Fever was present in all subjects. In the MIS-C group, evidence for cardiovascular system involvement was the most common feature followed by the mucocutaneous and gastrointestinal systems. In the “Near MIS-C” and “Alternative Diagnosis” group, gastrointestinal symptoms were the most common with only one patient with cardiac abnormalities and none with coagulopathy. Subjects with typical MIS-C presentation had higher inflammatory markers when compared to subjects in the other groups. Almost all the subjects had positive IgG for SARS-CoV-2. Of the 29 subjects, the Royal College of Paediatrics and Child Health (RCPCH) case definition would have identified all suspected cases without an alternative diagnosis as MIS-C, whereas the World Health Organization (WHO) and the CDC definitions would have excluded 6 and 10 subjects, respectively.ConclusionMIS-C presents a diagnostic challenge due to the nonspecific symptoms, lack of pathognomonic findings, and potentially fatal complications. More research is needed to fully understand its pathogenesis, clinical presentation spectrum, and diagnostic criteria. Based on our experience, we favor the hypothesis that MIS-C has a continuum of severity that necessitates revisiting and unifying the current definitions

Systemic Mastocytosis: A Mimicker of Reactive Arthritis

Objectives. Illustration of a case of systemic mastocytosis mimicking reactive arthritis in the absence of an infectious etiology. Methods. Review of the patient’s medical records. Results. We report a case of systemic mastocytosis relapse, presenting with pancytopenia accompanied by knee monoarthritis, cystitis, and bilateral conjunctivitis occurring simultaneously at the same time interval within 2–4 days, mimicking reactive arthritis in the absence of an infectious etiology. Conclusion. Our case demonstrated reactive arthritis features (triad of urethritis, conjunctivitis, and arthritis) without an infectious trigger but rather a relapse of mastocytosis. We should think outside the box when faced with such a clinical scenario in the absence of an infectious etiology. Paraneoplastic reactive arthritis is to be considered after excluding an underlying infection

Polyaniline/Bi₁₂TiO₂₀ Hybrid System for Cefixime Removal by Combining Adsorption and Photocatalytic Degradation

Sillenite catalysts have shown efficient photocatalytic activity for the removal of various pollutants from water in previous studies, thus enhancing their activity by combining them with other materials will be very promising for environmental applications. In this context, an interesting hybrid system containing Polyaniline (PANI) as an adsorbent and Bi12TiO20 (BTO) sillenite as a catalyst was proposed in this work. Cefixime (CFX) has been selected as a pollutant for this study, and its removal was evaluated using PANI (adsorption), PANI and BTO (combined system) and the hybrid system Bi12TiO20/Polyaniline (BTO/PANI). First, the impact of PANI adsorption was investigated on its own; after that, the solution was filtered to separate the adsorbent from the liquid in order to re-treat the solution using photocatalysis (combining adsorption with photocatalysis). At the same time, a similar technique was used involving the hybrid system BTO/PANI. The results show that the hybrid system can remove a very high Cefixime concentration of 30 mg/L, almost 100%, within only 2 h, and this is better than previous investigations. These results indicate that it is possible to combine photocatalysis and adsorption processes to control water pollution

Structural and electrochemical characterizations of Bi12CoO20 sillenite crystals: degradation and reduction of organic and inorganic pollutants

International audienceThe present contribution is to synthesize and characterize a new material photocatalyst. It also explores the possibility of using it to remove organic and inorganic pollutants in water. In this context, the sillenite Bi12CoO20 (BCO) in pure phase was synthesized by the combustion sol-gel method. The phase was identified by X-ray diffraction (XRD) then it was refined in the cubic symmetry in the space group (I23 N degrees 197) using the Rietveld refinement method; the lattice constant was accurately determined. A direct optical bandgap of 2.56 eV was evaluated using the UV-Visible diffuse reflectance. The electrochemical properties were investigated for the first time. A flat band potential of E-fb = 0.62 V-SCE was found with a p-type character; the hole density N-d = 54.2 x 10(17) cm(-3) extends the depletion width at 27 nm. The photocatalytic activity of BCO nanoparticles was tested to eliminate organic and inorganic pollutants namely the Basic red 46 (BR46) and hexavalent chromium Cr(VI). An acceptable rate was observed within 3 h for both contaminants

Are urologists underrepresented on fertility clinic websites? A web-based analysis

Introduction: Infertile couples frequently utilize the Internet to find various reproductive clinics and research their alternatives. Patients are increasingly using self-referral because of online information on health-care providers. The objective is to compare the image of infertility specialists to other team members on the websites of reproductive clinics. Methods: Information was gathered during November and December 2022 from two publicly accessible online registries which include the Human Fertilization and Embryology Authority located in the United Kingdom and the Society for Assisted Reproductive Technology located in the United States. We looked over every website that was accessible, paying close attention to how each team member was portrayed online. Results: We examined a total of 447 clinic websites. Only 8% of the profiles of male infertility doctors were included. Contrarily, most websites (96%), which specialize in reproductive endocrinology and infertility, feature the profiles of female infertility experts. Male infertility professionals also had significantly lower representation than other clinic employees, such as nurses (55.7%, P < 0.0001), directors of embryology laboratories (46.5%, P < 0.0001), office personnel (39.6%, P < 0.0001), and embryology specialists (29.7%, P < 0.0001). Conclusion: Although male factor infertility explains the existence of over half of all cases of infertility, urologists who specialize in male infertility are glaringly understated on websites for fertility clinics. By improving this issue, fertility clinics can draw in more patients by making all members of the care team more visible

A comparative study of ceramic nanoparticles synthesized for antibiotic removal: catalysis characterization and photocatalytic performance modeling

International audienceThe heterogeneous photocatalysis process has been known to provide significant levels of degradation and mineralization of emerging contaminants including antibiotics. For that, nanoparticle CuCr(2)O(4) (CCO) ceramics were successfully prepared via sol-gel (SG) and co-precipitation (CP) methods to obtain spinel with desired structural features and properties and also to improve the photocatalytic performances. The CCO crystallite phase was produced at 750 °C all ceramics, disregarding the synthesis route. CCO physical and chemical properties were checked by X-ray diffraction (XRD) with Rietveld refinement, Brunauer-Emmett-Teller (BET), Fourier transform infrared spectroscopy (FT-IR), scanning electron microscope (SEM), transmission electron microscope (TEM), and diffuse reflectance solid (DRS). The XRD patterns demonstrated that the synthesized catalysts displayed a small crystallite size between 17.45 and 26.24 nm for SG and 20.97 and 36.86 nm for the CCO(CP) samples. The observation by SEM and TEM of the nanopowders showed a typical morphology with comparable particle sizes for both synthesized routes (20-30 nm). SG agglomeration rates were higher, and particles stick together more efficiently considering the CP method, while the CCO(CP) method led to a more significant porosity. Their photocatalytic and adsorption performances were examined for cefaclor (CFC) removal chosen as a target pharmaceutical contaminant in water. The results obtained by the methods differed since nanoparticles prepared by SG led to high photocatalytic activity. In contrast, a high CFC adsorption was observed for those prepared via the CP method, and that agreed with the findings of the characterization analysis. The kinetics of the adsorption process was found to follow the pseudo-second-order rate law. In contrast, the data of the photodegradation process were further found to comply with the Lagergren kinetic law. Nevertheless, the global reaction rate is probably controlled by the intra-particular diffusion of CFC, regardless of the elimination process

Application of Bi(12)ZnO(20) Sillenite as an Efficient Photocatalyst for Wastewater Treatment: Removal of Both Organic and Inorganic Compounds

International audienceThis work aims to synthesize and characterize a material that can be used as an effective catalyst for photocatalytic application to remove both organic and inorganic compounds from wastewater. In this context, sillenite BiZnO (BZO) in a pure phase was synthesized using the sol-gel method. Before calcination, differential scanning calorimetry (DSC) analysis was done to determine the temperature of the formation of the sillenite phase, which was found to be 800 °C. After calcination, the phase was identified by X-ray diffraction (XRD) and then refined using the Rietveld refinement technique. The results prove that BZO crystals have a cubic symmetry with the space group I23 (N°197); the lattice parameters of the structure were also determined. From the crystalline size, the surface area was estimated using the Brunauer-Emmett-Teller (BET) method, which was found to be 11.22 m/g. The formation of sillenite was also checked using the Raman technique. The morphology of the crystals was visualized using electron scanning microscope (SEM) analysis. After that, the optical properties of BZO were investigated by diffuse reflectance spectroscopy (DRS) and photoluminescence (PL); an optical gap of 2.9 eV was found. In the final step, the photocatalytic activity of the BZO crystals was evaluated for the removal of inorganic and organic pollutants, namely hexavalent chromium Cr(VI) and Cefixime (CFX). An efficient removal rate was achieved for both contaminants within only 3 h, with a 94.34% degradation rate for CFX and a 77.19% reduction rate for Cr(VI). Additionally, a kinetic study was carried out using a first-order model, and the results showed that the kinetic properties are compatible with this model. According to these findings, we can conclude that the sillenite BZO can be used as an efficient photocatalyst for wastewater treatment by eliminating both organic and inorganic compounds

Synthesis and Characterization of ZnBi2O4 Nanoparticles: Photocatalytic Performance for Antibiotic Removal under Different Light Sources

International audienceThis work aims to synthesize a photocatalyst with high photocatalytic performances and explore the possibility of using it for antibiotic removal from wastewater. For that, the spinel ZnBi2O4 (ZBO) was produced with the co-precipitation method and its optical, dielectric, and electrochemical characteristics were studied. The phase has been determined and characterized by X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FT-IR). For the ZBO morphology, a Scanning Electron Microscopy (SEM) has been used. Then, the optical and dielectric properties of ZBO have been evaluated by calculating refractive index n (lambda), extinction coefficient (k), dissipation factor (tan delta), relaxation time (tau), and optical conductivity (sigma opt) using the spectral distribution of T(lambda) and R(lambda). An optical gap band of 2.8 eV was determined and confirmed. The electrochemical performance of ZBO was investigated and an n-type semiconductor with a flat band potential of 0.54 V_SCE was found. The photocatalytic efficiency of ZBO was investigated in order to degrade the antibiotic Cefixime (CFX) under different light source irradiations to exploit the optical properties. A high CFX degradation of approximately 89% was obtained under solar light (98 mW cm(-2)) only after 30 min, while 88% of CFX degradation efficiency has been reached after 2 h under UV irradiation (20 mW cm(-2)); this is in line with the finding of the optical characterizations. According to the obtained data, solar light assisted nanoparticle ZBO can be used successfully in wastewater to remove pharmaceutical products

Artificial neural network modeling of cefixime photodegradation by synthesized CoBi(2)O(4) nanoparticles

International audienceCoBi(2)O(4) (CBO) nanoparticles were synthesized by sol-gel method using polyvinylpyrrolidone (PVP) as a complexing reagent. For a single phase with the spinel structure, the formed gel was dried and calcined at four temperatures stages. Various methods were used to identify and characterize the obtained spinel, such as X-ray diffraction (XRD), scanning electron micrograph (SEM-EDX), transmission electron microscope (TEM), Fourier transform infrared (FT-IR), X-ray fluorescence (XRF), Raman, and UV-Vis spectroscopies. The photocatalytic activity of CBO was examined for the degradation of a pharmaceutical product cefixime (CFX). Furthermore, for the prediction of the CFX degradation rate, an artificial neural network model was used. The network was trained using the experimental data obtained at different pH with different CBO doses and initial CFX concentrations. To optimize the network, various algorithms and transfer functions for the hidden layer were tested. By calculating the mean square error (MSE), 13 neurons were found to be the optimal number of neurons and produced the highest coefficient of correlation R(2) of 99.6%. The relative significance of the input variables was calculated, and the most impacting input was proved to be the initial CFX concentration. The effects of some scavenging agents were also studied. The results confirmed the dominant role of hydroxyl radical OH(•) in the degradation process. With the novel CoBi(2)O(4)/ZnO hetero-system, the photocatalytic performance has been enhanced, giving an 80% degradation yield of CFX (10 mg/L) at neutral pH in only 3 h